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October 1959

Leukemoid Reaction in Infectious MononucleosisAn Infrequent Manifestation Simulating Leukemia

Author Affiliations


From the Department of Medicine, Harvard Medical School, and the Peter Bent Brigham Hospital; Chief Resident Physician, Peter Bent Brigham Hospital, and Assistant in Medicine, Harvard Medical School (Dr. Shipp), and Intern in Medicine, Peter Bent Brigham Hospital (Dr. Baden).

AMA Arch Intern Med. 1959;104(4):619-621. doi:10.1001/archinte.1959.00270100105017

Infectious mononucleosis, a common disorder in the young-adult age group, is well known for its protean features. Leukemia may be suggested when bleeding manifestations, thrombocytopenia, and hemolytic anemia are found in association with lymphadenopathy and splenomegaly. The leukocyte count rarely exceeds 30,000 per cubic millimeter.1 The following report is an example of infectious mononucleosis with the infrequent leukemoid response which may further mimic leukemia. The causes of a lymphocytic leukocytosis are reviewed.

Report of Case  The patient, an 18-year-old student, was admitted to the Peter Bent Brigham Hospital for the first time, on Nov. 20, 1956, because of fever of four days' duration. He had been well until nine days before entry, when sore throat, retro-orbital pain, and malaise began. Fever, headache, anorexia, nausea and vomiting, increasing malaise without chill, cough, chest pain, and gastrointestinal or genitourinary symptoms were noted during the four days before admission.Initial physical examination

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